Use of autologous rectus fascia in a new transobturator hybrid sling for treatment of female stress urinary incontinence: a pilot study.

ABSTRACT

OBJECTIVE: This article reports the early results of a novel sling used for the treatment of female stress urinary incontinence (SUI). This sling has a piece of autologous rectus fascia in its middle part and two arms of polypropylene mesh. MATERIAL AND METHODS: The study included 44 women with SUI. The preoperative work-up involved complete history taking, physical examination, cough stress test (CST) and 1 h pad weight test (PWT). Two questionnaires, the Urogenital Distress Inventory - Short Form (UDI-6) and the Incontinence Impact Questionnaire - Short Form (IIQ-7), were also completed preoperatively. The previously described sling was then inserted via the transobturator route in all patients. Postoperatively, the previous work-up was repeated for objective evaluation of the procedure and the subjective improvement was assessed by the Patient Global Impression of Improvement scale. RESULTS: At the end of the first year, 92.9% of the patients had a negative CST, 85.7% had 1 h PWT <1 g and the subjective cure rate was 90.5%. In addition, the scores for both UDI-6 and IIQ-7 were found to be decreased significantly (p < 0.001). The recorded complications included temporary urinary retention, dyspareunia, de novo urge incontinence and groin pain in 4.8%, 4.8%, 7.1% and 11.9% of patients, respectively. CONCLUSION: This hybrid sling appears to have good short-term efficacy and low cost.